KSU Traffic Court: Student Parking Citation Appeal Form

KSU Traffic Court

STUDENT^*Parking Citation Appeal Form

^*For Faculty, Staff, and Visitor Appeals, please contact the KSU Police Department

Please read the instruction sheet before filling out this form!

Mr. / Ms. / Mrs. (circle one)

Name: _____________________________________________ KSU ID#: ____________________________

Address: ___________________________________________    Phone: (        ) _______ - _______________
                     Street                                        Apt. #
                 ___________________________________________ License Plate #: ______________________
                    City                      State                   Zip

KSU Student Decal #: ________________ Citation # & date of citation:

NOTE: if you are NOT a KSU student,                     ______________________________________
you may NOT appeal to the Traffic Court.                Citation #                               date issued
Please contact the KSU Police Dept.

______________________________________

Citation # date issued

For the following reasons, I hereby appeal the above references campus parking citation(s) to the KSU Traffic Court: (use the back of this form or attach an additional pages, if necessary)

_______________________________________________________________________________________________

______________________________________________________ ________________________
Student's Signature Date

Please ATTACH A COPY OF YOUR TICKET, and return the completed form to the appeals box in the Student Center or the KSU Office of Judiciary Programs, 1000 Chastain Rd., Kennesaw, GA 30144.

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